Late last night, Portlanders rejected a plan to fluoridate their city’s water supply (and the water of over a dozen other cities). It’s the fourth time Portland has rejected the public health measure since 1956. It’s the fourth time they’ve gotten the science wrong.

When new medical treatments are implemented, when new drugs are introduced into the populace, there is always some hesitation. There are (hopefully) some clinical trials to back up the new intervention, but the long-term implications are often unclear. Water fluoridation doesn’t have this problem. For over 65 years, it has been rigorously tested as a public health measure, and considered one of the most successful measures of the last 100 years, alongside others like recognizing that tobacco use is a health hazard.

Simply put, the refusal of water fluoridation doesn’t have any scientific support. A review on fluoride’s effect on IQ out of Harvard was waved about as the main scientific opposition, but has since been thoroughly refuted. Decades of studies in different cities in different states, involving millions of people, have concluded that there is a safe level of fluoride—one part-per-million—that can be added to water for enormous benefit to our teeth and oral health with little to no adverse effects.

Without a study to stand on, the main opposition to water fluoridation seems to be political. It is almost understandable that Portland could stand up to health experts and refuse fluoride. Part of the American experiment was letting states decide for themselves what’s best for them and giving citizens the freedom to criticize government action. But the opponents of water fluoridation are boxing with a ghost. There are no known victims of water fluoridation. There are no cities receiving a toxic concentration of the ion. Water fluoridation isn’t just the addition of fluoride; it’s the regulation of fluoride in the water supply. The ion occurs naturally in ground water in varying levels, some that are in fact too high. When this is the case fluoride is actually removed from the water to get the greatest benefit. Arguing against having a regulated supply of fluoride in your water is like an anemic refusing to take iron supplements. The doctor isn’t trying to add enough iron to your blood so that Magneto could pull it out; she is trying make sure the levels in your blood are right for health.

“Keep Portland Weirdly Out Of Touch With Modern Medicine”

Portland is a lovely, if a little rainy, city replete with greenery, mountains, and some of the most interesting nightlife you will ever see. But chemophobia is in the air. Fluoride—an aggressively electronegative atom with an extra electron—has been singled out for scrutiny with a smear campaign. The charge against this negatively charged particle uses propaganda laced with a high concentration of fear-inducing terms and mischaracterizations to rally a small but highly vocal base.

Because there is no evidence that a regulated amount of fluoride in our water is causing harm—the reality is just the opposite—graphic posters like this one on the right color the conversation. Poison? Insecticides? Bone cancer? Why would Portland fluoridate if this poster were right?

But it isn’t. The fear of fluoride follows the same playbook for mischaracterizing chemicals. First, the chemical is labeled “toxic,” but it isn’t mentioned that everything is toxic in the appropriate amounts. Advil and Tylenol are toxic at high enough concentrations, as is water. Many chemicals are harmless within a range of toxicity, and many are beneficial up to certain point. Next, the chemical’s dangerous effects at massive concentrations are stated. But 1/100 or 1/10 of an ounce of fluoride would never be in a glass of tap water in a regulated area—indeed, you are much more likely to find dangerously high levels of fluoride in unregulated water supplies. One part-per-million is the recommended dose, and so one ion floats among a million water molecules. What happens at higher doses can be terrible, which is precisely why you won’t find those levels in regulated water supplies.

The final effort is to link the chemical to other scary things that contain it. This may come as a surprise, but it shouldn’t scare you—your body produces formaldehyde. It does so naturally, but the chemical doesn’t damage or kill you. It’s all about the dose; it makes the poison. Just as a natural amount of formaldehyde in your body isn’t a cause for alarm, neither is a regulated, and proven beneficial, amount of fluoride in your water.

And the fear is selective. Where is the anti-chlorine lobby? Chlorine is a chemical—also an ion—added to water, also considered one of the greatest public health measures in history. It too is proven to reduce disease and create a more healthy population. Chloride has all the attributes that make fluoride “scary.” When an identical situation produces almost no blowback, it speaks to the basis of fluoride fear. It’s not science.

Posters and information campaigns like the one above have caused more damage to the reputation of chemicals than yesterday’s vote. The chemophobia playbook has tattered edges and frayed bindings. The game plan for destroying public support for a chemical is tired, disparaging, inaccurate, and it worked in Portland.

Chemical Conspiracy

“Portland is wrong about fluoridation” is exactly what a government shill would say, isn’t it?

The claims against fluoride are overblown, the science deems it safe, so what’s left are the conspiracy theories claiming it to be a mind control agent or a dumbing-down recipe fed to the helpless sheeple. Though a conspiracy is nigh impossible to refute—every piece of evidence against the conspiracy is “part of the conspiracy”—the supposed fluoride conspiracy is nigh impossible to accept. While we sit in stagnant congressional deadlock, accepting a fluoride conspiracy means answering “yes” to all the following:

Could the government…?

Control each and every scientist who has ever published a study on water fluoridation?

Control each and every website that promotes the use of fluoridation?

Have significant private control of the infrastructure of the Internet to suppress conspiracies?

Keep every government employee or scientist who knew about fluoridation for the last 65 years from mentioning one word about its dangers at recommended levels?

Control and coordinate advocacy groups on the local level to write reports and organize in favor of the process?

Have the time and resources to conduct all these suppressive operations for half a century?

Fluoridation conspiracy theorists can’t trust the government to safely add/remove something to/from their water—as they do for chlorine, cryptosporidium cysts, carbon-based solids, oil, grease, arsenic, lead, and selenium—but will give the government the benefit of the doubt when it comes to policing every shred of information on fluoridation for the last 65 years. As with most conspiracies, pulling on the thread unravels the theory.

And if water fluoridation is a grand conspiracy, at least it’s a safe and cost-effective one. The CDC estimates that every $1 invested in the practice saves approximately $38 in dental costs.

The freedom to question the government that makes America great is a banner that shades our most cherished values. Sometimes, the shadow creeps too far. Should we have the freedom to refuse a critically important public health measure? When the enshrinement of autonomy bleeds into areas where personal opinion is the lowest form of evidence, it leads to perplexing questions about whether or not we have a right to be less healthy by choice.

Portland has the right to keeps fluoride out of its water because the battle cry of American freedom trumps a data point on a graph. Even when surveys of 1st-3rd grader’s dental health recommend water fluoridation, the issue is contorted and amplified into a political screech with unpleasant lows and cringe-worthy highs. Portland remains out-of-step with dental health by choice, by political motivations, and by often-valid concerns over government intrusion. Yesterday’s vote was a failure of science communication, and it falls on public health officials to rectify that, to take back the word “chemical.” Perhaps re-framing the conversation in terms of dental health or water fluoridation as regulation, not just addition, could help. Until political questions are seriously informed by scientific answers, fear and freedom beats facts.

Science can lead a man to fluoridated water, but it can’t make him drink.

123 Comments

How can a scientifically illiterate population have a properly functioning democracy in the modern age when we are surrounded by technology? The american people have shown time and time again that they are incapable of making rational decisions based on sound science. Instead they succumb to religion, political ideology and paranoia. Americans arm themselves and their children from invasion by the king of England but it seems an intelligent king is what they need to save them from themselves.

It does not matter if they have the science wrong or not. putting fluoride in water is an unneeded expense. Since I became an adult some 30+ years ago I moved out of the city and have had only well water since and I have not had a cavity since I left the cities fluoridated water.

Kyle, while I always enjoy a good rant, yours is weak on evidence. Why don’t you ask a Portlander who voted “no” for their reasons? I doubt they will point to an anti-science campaign. BTW this is the fourth time Portland has rejected fluoridation, so perhaps something deeper is at work than you surmise?

The fluoridation conspiracy is one of the oldest on record. You are going up against a very long history of fear. You didn’t really examine the history of this in your piece nor did you mention any of the nations that have stopped using it, some of them supposedly well educated and moderately socialist. Those countries sort of go against the historic position in America that fluoridation is part of a socialist plot. Those crazies are still a force in conservative politics and they oppose other government health programs.

I’m wondering will Portland not regulate fluoride at all? So if too much fluoride is found to be naturally present in the water Portland will not remove it?

Could you lay out those legitimate concerns? Whatever they are, they haven’t seemed to hamper the rest of the US (and the majority of Europe), who have been fluoridating with great effectiveness for the last half-century.

“…the effects were generally small…In Portland metro, there was no evidence of a beneficial effect of fluoridation on total costs; in fact, costs were generally higher among members living in the community water fluoridated (CWF) than in the (NF) nonfluoridated districts of the metropolitan area”

Citation – A comparison of dental treatment utilization and costs by HMO members living in fluoridated and nonfluoridated areas” J Public Health Dent. 2007 Fall;67(4):224-33

Consider this: 800,000 Oregonians (1:5) are on food stamps. Portland saved millions of dollars that can now be better spent on really helping people with live and death issues (including insurance). People need doctors, and fluoride is not going to address gum disease, braces, oral cancers etc. Nor will it bring dental caries to zero.

It’s easy for Scientific American and other to criticize Portland’s spending when their not the one’s footing the bill. Perhaps a little more humility is in order?

Frankly, it’s perverse to see how proponents of fluoridation fetishize and obsess over cavities, diminishing our complex mental, physical and psychological needs to the amount of holes in a tooth.

This wasn’t a “rant”; it was showing that the opposition doesn’t have a basis in science.

It shouldn’t be insulting. Either the opposition cares to use science to inform their positions, or they don’t. If the latter, the fact that science doesn’t support them shouldn’t matter. If the former, then the rational response is to either A) Refute it or B) change their position. Simple as that.

Kyle, throughout my life, opposition to fluoridation has been associated in my mind with general-purpose crack-pottery and, specifically, with crazed right-wing anti-science, anti-government zealotry, to such an extent that I never even bothered reading a single article on the subject. Why immerse myself in this intellectual cesspool?, I thought.

But a few years ago (2007 to be precise) a powerfully argued, highly evidence-based article, in Scientific American no less, suggested that it was those who blithely DISMISSED the dangers of fluoride who were the irrational ones. Ever since, I’ve taken an interest in the subject, reading every article I encountered on the issue–perhaps as a penance for my former close-mindedness. And so, when I saw the topic of your blog post, of course I clicked on it.

Despite your being a “science writer”, rarely have I encountered as false, and more importantly, as unscientific a statement as this one of yours: “Simply put, the refusal of water fluoridation doesn’t have any scientific support. A review on fluoride’s effect on IQ out of Harvard was waved about as the main scientific opposition, but has since been thoroughly refuted. Decades of studies in different cities in different states, involving millions of people, have concluded that there is a safe level of fluoride—one part-per-million—that can be added to water for enormous benefit to our teeth and oral health with little to no adverse effects.”

Literally, not one idea conveyed in those sentences of yours is true. Particularly egregious is your comment, “A review on fluoride’s effect on IQ out of Harvard was waved about as the main scientific opposition, but has since been thoroughly refuted.” I urge readers of this comment to read both the study from Harvard and what Kyle would have you believe is its “thorough refutation”. First of all this “thorough refutation” consists of a BLOG POST!!!! Yes, ladies and gentlemen, Kyle cites not a careful scientific study but a blog post. Furthermore, that cited blog post actually disparages the Harvard study by saying it wasn’t really a “study”, that it contained no “new data”. What in fact was the Harvard study? It was a meta-analysis, what any good scientist recognizes is a far better way of getting at the truth than a single conventional trial.

In reading the Harvard study itself (which is available free online and is linked to by the blogger I just cited), you find powerful evidentiary support for the thoroughness of this damning Harvard meta-analysis, the inadequacy of prior studies, the fact that deliberate fluoridation of water produces potentially dangerous levels of fluoride, and the true threat of fluoride—neurotoxicity in children:

First the broad scope of the evidence examined in this study:

“Findings from our meta-analyses of 27 studies published over 22 years suggest an inverse association between high fluoride exposure and children’s intelligence.”

Next, the inadequacy of prior studies:

“As noted by the NRC committee (NRC 2006), assessments of fluoride safety have relied on incomplete information on potential risks. In regard to developmental neuro-toxicity, much information has in fact been published, although mainly as short reports in Chinese that have not been available to most expert committees.”

Third, this comment, which incriminates levels of fluoride comparable to (and often lower than) those prevailing in water that is deliberately fluoridated in the United States, (bear in mind as you read the next quote that the recommended level to be attained when water is deliberately fluoridated is up to 1.2 mg/L):

“A recent cross-sectional study based on individual-level measure of exposures suggested that low levels of water fluoride (range, 0.24–2.84 mg/L) had significant negative associations with children’s intelligence (Ding et al. 2011). This study was not included in our meta-analysis, which focused only on studies with exposed and reference groups, thereby precluding estimation of dose-related effects.”

Finally, the authors of the Harvard study make this powerful point about the very real, and gravest, potential danger of fluoride–neurotoxicity in the young, those whose brains are still developing:

“The results suggest that fluoride may be a developmental neurotoxicant that affects brain development at exposures much below those that can cause toxicity in adults (Grandjean 1982). For neurotoxicants such as lead and methylmercury, adverse effects are associated with blood concentrations as low as 10 nmol/L. Serum fluoride concentrations associated with high intakes from drinking water may exceed 1 mg/L, or 50 µmol/L—more than 1,000 times the levels of some other neurotoxicants that cause neurodevelopmental damage. Supporting the plausibility of our findings, rats exposed to 1 ppm (50 µmol/L)of water fluoride for 1 year showed morphological alterations in the brain and increased levels of aluminum in brain tissue compared with controls (Varner et al. 1998).”

My brief excerpts from the Harvard study don’t do full justice to its careful and penetrating analysis of the possible effects of fluoride, particularly on children. I urge everyone to read the actual study, and decide for themselves whether Kyle’s assertion that “the refusal of water fluoridation doesn’t have any scientific support” itself has any scientific support.

And let’s remember one thing: everyone is free to use fluoride-containing toothpaste, or to add fluoride to their diet. Why compel the entire population, including millions of children, to ingest a substance which is, AT BEST, of unknown toxicity? And for what—preventing a few cavities?

Kyle, that is incorrect use of logic. In your article you pointed out the irrationality of the American people. To use the fact that American people subscribe to fluoridation despite ‘legitimate’ concerns, making these ‘legitatmite’ concerns non issue discredits you as an author and critical thinker.

That being said, the reasons the residents of Portland have for choosing not to accept fluoridation are non issue. The real issue at hand is the tolerance of a person’s autonomy to choose an unsubscribed modality. A Democracy may be made up of irrational thinkers but those irrational thinkers still chose. It is still a Democracy.

I agree with your sentiments of failure to educate the people. Rational thought is not possible without both arguments presented. Educating citizens versus taking autonomy away would be the ethical thing to do. Individual rights would be preserved, ensuring that if people do chose the option not recommended, well at least it wasn’t because they were misinformed.

As a civil engineer specializing in water resources, I can tell you that this flouridation issue has raged for the past four years. The professional journals I receive generally have numerous articles on the pros and cons of flouridation.

Suffice it to say that the people of Portland, Oregon live in an uber-liberal city and don’t drink the municipal tap water–they buy bottled water from Florida. Also suffice it to say that the good folks of Portland, Oregon probably don’t suffer from bad dental health since sodium flouride is so prevalent in almost everything we consume these days and in every tube of toothpaste we buy.

People on municipal water systems wind up with flouride in their water because the US government gives grants which purchase the dosing equipment and some supply of sodium flouride gas. It’s an old grant program, so I suspect that the Washington crony who sold the feds on the program is long dead and gone.

BTW, Mr. Hill, the reason there is chlorine in the water is by EPA rule which requires disinfectant residual in piped public water systems. And yes, overdosing a system with chlorine CAN and does cause human ailments. However,EPA is kind of funny about its calculations on toxicity limits pertaining to human health. In a very well-known case, EPA has established copper limits for drinking water and for wastewater effluent discharge, both based on a human health criteria. However, in a collosal mathmatic error, EPA set the copper limits for drinking water 400 times greater than for wastewater discharge. Water professionals have pointed out this math error for years, but EPA is arrogant and, in their own minds, never wrong.

The science on flouridation is anything but settled. Avoiding excess sodium flouride is probably a safe, conservative approach. Considering the liberalism of Portland, Oregon, conservative approaches are a rare occurrence in that neck of the woods.

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This discussion could use a little local context. The Bull Run reservoir was established over a century ago and the entire watershed is protected land, mostly old growth forest. It has essentially served the city with clean water through modern times without much need for upgrade or treatment. There is a recent political history of the Federal government instituting mandatory upgrades to various components of the Portland water system to bring it in line with standards. The public has mostly resisted these changes for various reasons ranging from “It’s poison!” to “If it ain’t broke don’t fix it.”

For those asking, no fluoride is detected in the bull run water supply and very little exists in auxiliary groundwater sources.

We do not question that fluoride in very limited and controlled doses probably causes minimal or even no harm. At higher levels, there is universal scientific consensus that fluoride causes harm, from lesser effects like fluorosis to more severe effects like cancer, kidney problems, etc.

Where the debate lies is the administration of dose. Your analogy to iron, Tylenol and Advil is wholly without merit, because with those and other drugs/supplements, dose is measured on a per person basis, sometimes under the care of a physician or if not, at least controllable by the individual. Mass fluoridation of water utterly fails to properly measure dose and assure each individual does not exceed the recommended dose. Some people drink much more water and all of us get fluoride from other sources such as food and soft drinks. In fact, this is exactly why the CDC only two years ago nearly cut in half it’s recommended water fluoridation dose (from 1.2 to .7 ppm). So, even the CDC has come to realize that our communities have been receiving way too much fluoride over the past fifty years. Whoops…what if they are wrong again, and discover that we are in fact getting way too much even now? The damage will have already been done. And the evidence supports this: since fluorosis is scientifically proven to be solely caused by excessive fluoride ingestion, we must reasonably conclude that our fluoride ingestion has been increasing over the past few decades.

We Portlanders are not idiots, nor are we sheep responding to fear-mongering. We are a very well educated and questioning city and many of us have spent considerable time reviewing scientific studies and have concluded that delivering this medication, with known adverse health effects and an inability to properly measure/monitor/alter dose is a bad idea and deprives people of choice. And we are independent minded enough to question mainstream opinion and make our own decision. Oh, and by the way, Portland’s cavity rate is significantly lower than many fluoridated communities, and so many of us think that their are better, less intrusive ways to improve dental health, and so money and effort should instead be focused there.

In short, this is a legitimate debate on this topic, and it is offensive when the pro-fluoridation folks continue to demonize the other side as quacks, utterly ignore the growing scientific debate, and fail to even attempt to understand, let alone respect, our decision to opt out of fluoridation.

I feel like you didn’t due a lot of research in writing this article. You say that fluoridation has been “rigorously tested” but the York Review (one of the citations listed by the CDC) has this to say in it’s conclusions:
“This review presents a summary of the best available and most reliable evidence on the safety and efficacy of water fluoridation.
Given the level of interest surrounding the issue of public water fluoridation, it is surprising to find that LITTLE HIGH QUALITY RESEARCH has been undertaken. As such, this review should provide both researchers and commissioners of research with an overview of the methodological limitations of previous research conducted in this area.
The evidence of a benefit of a reduction in caries should be considered together with the increased prevalence of dental fluorosis. The research evidence is of INSUFFICIENT QUALITY to allow confident statements about other POTENTIAL HARMS or whether there is an impact on social inequalities. This evidence on benefits and harms needs to be considered along with the ethical, environmental, ecological, costs and legal issues that surround any decisions about water fluoridation. All of these issues fell outside the scope of this review.
Any future research into the safety and efficacy of water fluoridation should be carried out with appropriate methodology to improve the quality of the existing evidence base.” (emphasis mine)
The rigorousness of the research out there is really, very questionable.

Also, you are quite correct that the government would not be able to “Keep every government employee or scientist who knew about fluoridation for the last 65 years from mentioning one word about its dangers at recommended levels” because, in fact, it hasn’t. Several EPA scientists have spoken out against water fluoridation (http://www.nteu280.org/Issues/Fluoride/NTEU280-Fluoride.htm) and they base also base their opposition on science.

There is nothing-Nothing-that has all benefits and no risks. Fluoride, even in small amounts, might very well have some risks that we don’t know about because the quality of the scientific studies is so poor. Just because it (probably) won’t kill us doesn’t mean it’s healthy and justified. Clearly, rampant decay can exist in fluoridated areas and fantastic dental health can exist in unfluoridated areas, so the correlation is not even as strong as it ought to be in order to be really significant… scientifically speaking.

“Simply put, the refusal of water fluoridation doesn’t have any scientific support.”

I’m not even going to bother reading the rest of this smear piece when that statement is so blatantly false. For starters, let’s look at public statements from key panel members of the NRC 2006 report:

Dr. Robert L. Isaacson: “I had no fixed opinion on whether or not fluoride should be added to drinking water … Slowly, I came to the conclusion that there were strong experimental and clinical indications that fluorides present health hazards to people in many ways. The more I learned, the more I became convinced that the addition of fluorides to drinking water was, and is, a mistake.”

Dr. Hardy Limeback: “The evidence that fluoridation is more harmful than beneficial is now overwhelming.”

Dr. Kathleen Thiessen: “Elimination of community water fluoridation at the earliest possible date would be in the best interest of public health.”

Jeezes!
I got as far as “(bear in mind as you read the next quote that the recommended level to be attained when water is deliberately fluoridated is up to 1.2 mg/L)”

No. One part per million means .001 mg/L
Typical conspiracy tactic: use scientific data and muddle it, mix misguiding “facts” with the data to drive the desired (false) conclusion home. You’re just too froggin’ obvious, dude. Skipped the rest of the rant after this, sorry.

Having said that, JEEZES PEOPLE! it’s a democracy, they voted, they decided, let them be.

“A long habit of not thinking a thing wrong gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom.” —Thomas Paine

“A truth’s initial commotion is directly proportional to how deeply the lie was believed. It wasn’t the world being round that agitated people, but that the world wasn’t flat. When a well packaged web of lies has been sold gradually to the masses over generations, the truth will seem utterly preposterous and its speaker a raving lunatic.” –Donald James

“In science it often happens that scientists say, ‘You know that’s a really good argument; my position is mistaken,’ and then they would actually change their minds and you never hear that old view from them again. They really do it. It doesn’t happen as often as it should, because scientists are human and change is sometimes painful. But it happens every day. I cannot recall the last time something like that happened in politics or religion.” ―Carl Sagan

“One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It’s simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.” –Carl Sagan

That’s a current quote directly from the water bureau. If you read somewhere that Portland already has water with some detected fluoride you are likely reading a reference that studied all of Portland’s water sources. See: In addition to the Bull Run Watershed we have back up well fields. Those can contain detectable levels of fluoride. But: Those back-up well fields are only used ~ 2 weeks per year, when too much sedimentation is occurring because of past secretive/illegal logging in the watershed.
To learn some more about the history please read this article: “The Battle of Bull Run” by Douglas Larson in ‘American Scientist’: http://www.americanscientist.org/issues/id.6324,y.0,no.,content.true,page.1,css.print/issue.aspx

To Acoyauh2 , regarding my statement about the level of fluoride that should be attained when fluoridating water: I was quoting directly from the Harvard study, which I’ll do again now, in greater detail, as they speak of fluoride levels:

“in many cases concentrations were above the levels recommended(0.7–1.2 mg/L; DHHS) or allowed in public drinking water (4.0 mg/L; U.S. EPA) in the United States (U.S. EPA 2011).”

“The fact that nearly 3 out of every 5 communities which vote on the issue have rejected fluoridation, year after year, does in all likelihood represent a collective judgment on the part of the public that, when all things are considered, fluoridation is not an acceptable public health measure.” –Edward Groth, PhD

i love the condescending remarks about conspiracy theorist in this article, i feel so foolish worrying about my children’s health now. Why does this article reek of propaganda. you forgot to mention where they get the fluoride from ?It’s funny how many articles i read from angry scientist in america claiming that they can’t get a paper published if the research has any negative results against fluoride, maybe thats why the government doesn’t need to control every scientist.It doesn’t take a mental giant figure out that drinking fluoride for anti tooth decay is ridiculous! why would you ingest something for your teeth? brushing with fluoride isn’t enough ? you need to drink it also ? wtf. and please explain to us what is wrong with having pure water without fluoride. scientific American did you sell out ?

Another thing , it’s really getting annoying how the media has become the governments whore. Why is it so hard to get the truth anymore? this article makes no sense! drink fluoride for cavity prevention, well i guess i should drink mouthwash for bad breath also. how about if we all start drinking suntan lotion so we don’t get skin cancer! come on, we are not that stupid , it’s insulting that you think we are.

I’m a Portlander and a strong supporter of water fluoridation. This article got something very important wrong. The author states that “Water fluoridation isn’t just the addition of fluoride; it’s the regulation of fluoride in the water supply.” While this might be true most places, it is not true in Portland.

Our water supply comes from rain and snowmelt, not from a river or aquifer, and has naturally low levels of minerals, including fluoride. The levels are on the order of .1 – .3 ppm. Our water’s long and strong reputation for purity has likely influenced the idea that we should not add anything to it. There is much less awareness that we add the same things every other city does, with the main difference being that we are able to add low enough levels of chlorine that the taste is barely perceptible.

And the anti-chloride lobby? I set one up to demonstrate the fallacies of some anti-fluoride arguments. Don’t hesitate to join up and support my efforts!

I am tired of dealing with people who’s impression of Portland is from a stupid show written by non-natives, and all the actors are not from Portland. There is nothing in that show that I recognize…
Portland has one of the highest educated populations, it is also young.
Portland has better teeth then about any fluorinated city.
Harvard medical studies in China showed negative impacts to IQ in kids who drank fluorinated water.
Even through the CDC supports fluorination of water supplies, none of its studies shows evidence that ingestion of fluoride has any impact on tooth decay. The only collation to tooth health is public access to dental care. Since Portland has a high level of access (free dental clinics) it has a low rate of decay. Cities that have fluorinated for decades can’t match our rates…because drinking fluoride doesn’t prevent tooth decay, only applying it topically does.
The World Health Organization studies show putting fluoride in tap waters does not reduce cavities.
Europe doesn’t floriated its water, because their medical studies show that it 1) doesn’t work, 2) had negative impacts on the health of people on Chemotherapy or other nerve sensitive diseases, or thyroid conditions – they are still arguing if it is the fluoride or the increase in arsenic that comes with fluorinating water.
The fluoride added to water is not the natural mineral, but an industrial waste product from the fertilizer industry and is heavily contaminated with arsenic, lead, mercury and berillium. Adding industrial fluoride to the water supply frequently causes the water to exceed the Federal guide lines on arsenic levels in many US cities.
During the elections – two cities in the US that do put fluoride in their water, had to shut down their systems, because the software had bugs and put in too much fluoride in the water … and it is a poison – which is why it is regulated by the FDA. The citizens of those towns were warned not to drink the water, because high concentrations would make them sick.
Portland has a budget crises – and the new fluoride program would have cost the water rate payers 5-7 million dollars, at a time when it is closing schools and increasing class size. Portland is overdue for a 9+ earthquake. In our disaster recovery exercises, the estimated dead if the earthquake hits during the day is 19000 – of which 17000 will be students, since to save money – since the 1970’s our public schools are exempt from building codes for fire/earthquakes ect… our schools are old, brick and multi-story. The money spent on fluoride would be better spent on fixing one of our schools to earth quake code that would lower the projected death rate by 1000. Which would do those kids a lot more good than fluoride.
Portland has a large wine/beer/and agricultural industry – fluoride is not good for any of these industries and would impact our economy negatively.
So perhaps the voters of Portland who have rejected this four times now, know something you don’t? Bet you were the same folks who believed science when it said smoking didn’t cause cancer or climate change? The science is not there… the folks in Portland are not all pot smoking hipsters… they are mostly Engineers in the Tech Valley between San Francisco and Seattle… and hey they have kids… and great social services for the poor, the reason you see so many poor in Portland, is because they are coming here from your cities, because we do care and provide more services than most places. And they are more likely to get dental care here. So go back to your vapid bashing of Portland, ignore your local poor and doing anything that would really help them, and laugh at us then we don’t blindly follow the crowd.
Because really your only argument is that , hey we are all doing it , and we are fine – why aren’t you? Are you strange or something? Grow up, you are not the popular cliché in high school – and some of us can think for ourselves. (Not to mention it is weird how all the news sites are running the same damn story… which corporation paid for this? Huffington Post, Salon, Slate…. All the same story… no original thought or angles – kind of like those clips John Stewart makes fun of….. )

If the only benefits are oral health issues, then why isn’t fluoride in toothpaste sufficient? If it’s not, then why not add more to the toothpaste?
Maybe the levels added to drinking water are safe for humans,(though I don’t really think It’s a good idea), but do we know they’re safe for every organism exposed to our wastewater and runoff from watering lawns, crops, etc?.
You lose a lot of credibility when you call a blog post a thorough refutation of a publication from a respected university, especially when their primary criticism is a lack of original data.
You have introduced to my thinking a substantial level of doubt regarding the credibility of scientific American with this single article.

Ozone treatment may be a better option than chlorination. Regardless, there are some important differences between chlorination and fluoridation of water. Chlorine is used to treat water, not the human body, so you can filter out the chlorine and still have sterile water. Chlorine serves a purpose, which is to kill living organisms in the water, unlike fluoride in water, which is good for nothing. Chlorine does not accumulate in the human body, whereas approximately 50% of ingested fluoride is stored in calcium-rich tissues such as bones, teeth, and the pineal gland (in the brain), with serious health implications. For babies that figure is up to 90%, and babies have been identified as a group at higher risk of fluoride toxicity. Chlorine is also much easier to filter out than fluoride. Reverse osmosis filters cost about $200 or more, and can’t be used as shower filters. Sterilisation of water may be a necessary evil, but fluoridation is just evil.

Science, or rejection thereof, was not the exclusive reason Portlanders rejected fluoridated water. Fluoride is already provided free of charge (free of charge to the patient and paid for by taxpayers) throughout the public school system as well as through several pharmacies. Those living below the poverty-line have easy and extremely low-cost or no-cost options for getting fluoride for their children.

The Pro-fluoride groups refused at every attempt to have any type of dialogue regarding the effectiveness of fluoridated water and continued to provide answers without any type of detail beyond “it’s peer-reviewed”. Portlanders demanded actual answers and nothing could be provided other than citing how many groups and bigger cities were already fluoridating their water. Statistics on whether or not fluoridated water works are fuzzy at best. “Just because” doesn’t work in Portland.

It is very simple and cheap to take fluoride if you want it, but is extremely difficult to avoid if it is added to the water supply, it would be in our food, pop, beer and anything else made with water, and is extremely difficult to filter out. so the burden on people that wish to avoid fluoride would be much greater than those wishing to take fluoride. This reason is why I voted against fluoride

“People should not be compelled to take medication no matter how good it is for them.”

This is the EXACT mistake that the anti-vaccine crowd makes and now we have whooping cough and other preventable diseases back on the rise. I don’t appreciate them degrading the “herd immunity” that vaccines provide to children. Or the people that don’t wear seatbelts because they don’t like the government telling them what to do. Well, to those people I remind them the I don’t like paying to scrape them off the pavement when they are ejected from their vehicle in a crash. In our strongly interdependent world, your freedom to put yourself and your family in danger due to illogical behavior STOPS when that freedom starts impacting others, whether it be in the pocketbook or in the hospital emergency room.

With fluoride, the cost of dental insurance goes up as people have more cavaties. In addition, poor dental health is linked to a variety of other maladies like heart disease and lung infection, driving up health insurance rates for everybody else.

@rkipling out-of-state conservatives provided maybe 70% of their money, Water filter and baking soda salesman Joe Mercola provided much of the difference. He is more libertarian, but also a snake-oil salesman.

The Portland voters were informed by both sides – hearing scientific arguments in favor and against fluoridation – and chose not to fluoridate.

Portland is an EXTREMELY cosmopolitan and educated city, with a vibrant academic community and a world-class high-technology scene. No, we were not misled. We’re not drugged out. We’re just thinking for ourselves, apparently. And reading the research, while looking at the money trail of what we are reading.

Is, “I brush my teeth, so I don’t need to ingest fluoride” a good enough reason not to want fluoride in my tap water? Also, I’m not saying fluoride is asbestos, but asbestos was deemed safe at the time, too.

I wouldn’t have voted for fluoride because I don’t think people need more chemicals introduced into their body than they already get from every day sources.

Kyle, you talk about a magical “one-part per million” dosage as the holy grail of fluoride dosing. Does this tell us exactly what dosage the “patient” is receiving? I’m personally concerned about the uncontrolled administration of a potentially dangerous substance. Not only do the total daily dosages vary widely between individuals based on their day-to-day consumption of water, but their fluoride intake will be affected by fluoride toothpastes (which children tend to swallow more frequently than adults) and by other sources such as foods, mouthwashes and other sources. Consequently, we have a potentially toxic chemical being administered in unknown dosages to the general public–including infants, elderly and infirm individuals. This IS a cause for concern.
Secondly, there is NOT a clear consensus regarding the efficacy OR safety of the chemical. The WHO set a ‘general guideline’ of 1.5 mg/L concentration as ‘safe’. However, in 2006 the United States National Research Council formed a 12-person committee to review the health risks associated with fluoride adulterated water. They unanimously concluded that the maximum contaminate level of 4.0 mg/L should be lowered. Three of the panel members openly expressed opposition to water fluoridation after the study and the chair stated that the issue should be re-examined.
Until such time that the questions of safety & efficacy have been fully examined, I for one, will not subject myself and my family to the guinea pig’s role of test subjects. Thanks but no thanks.
Incidentally, if all of you in favor of using fluoride are convinced that it’s the right thing to do, then by all means use fluoridated toothpastes and mouthwashes or talk to your dentist about periodic fluoride treatments. Just don’t expect everyone to follow your potentially risky actions.

http://www.nature.com/bdj/journal/v199/n7s/full/4812863a.html
This provides a pretty full explanation for fluoridated water. I’d scroll down to Effectiveness of Water Fluoridation first: “The early studies reported reductions in decay experience of the order of 50% or more. That was at a time when fluoridated water offered the only significant source of fluoride.” As for health concerns, I think more research is needed to ascertain whether it is dangerous or not.

OK regardless of the science behind this, even you yourself stated that 1 ppm (by the way naturally occurring fluoride already exists in that amount in most water suplies, so why add more?) can be added with “little to no adverse affects” theres that term “little”. If water is necessary for life and if I must drink it, should I not have absolute control over what drugs are put into it? doesn’t that make sense to you? if people want fluoride in their water fine, they can get special fluoride tablets from the store. or maybe even get them delivered in specially sealed government baggies with nice little labels on them that say “We care about your teeth, America”. but keep the drugs out of my water please. ever herd of a term called Informed Consent? no? google it.

This article is garbage, Kyle. I tip my hat to Portland for making the right choice. God bless those people. You don’t “medicate” a population via the water supply, it’s freaking absurd. There’s no reason I should have to drink a poison because others can’t remember to brush or floss. Not to mention all the other studies showing neuro-degenerative effects. I’m sure they’ve all been “thoroughly refuted” though. LAUGHABLE!

I’m still cleaning the vomit off my shit after reading your absurd comment: “Simply put, the refusal of water fluoridation doesn’t have any scientific support.”

Should I be amazed or merely amused that fluoridation danger deniers’ behavior is reminiscent of global warming deniers’ behavior?

In both cases there’s a dogmatic adherence to a predetermined point of view, and a truly shocking refusal to consider the evidence thoroughly and systematically. Or in the case of Kyle Hill, a refusal to consider the evidence at all, even though in Comment #8, in response to a commenter saying he had legitimate concerns, Hill said, “Could you lay out those legitimate concerns?” as though he intended to address them. Since then, many commenters, including myself, have laid out more than just legitimate concerns, we’ve presented hard evidence.

So I challenge you, Mr. Hill, to respond as you suggested in #8 you would. If you fail to do so, it could only be because once you actually considered the specific evidence and arguments you realized no meaningful rebuttal was possible.

Here’s what you need to respond to Mr. Hill:

1)The principal health concern with fluoride is its neurotoxicity in children, whose developing brains are far more vulnerable to all toxins than adult brains, as lead and mercury poisoning attest.

2)It is now well-established that children in areas with naturally high levels of fluoride in drinking water have statistically and educationally significant deficits in IQ. In the Harvard meta-analysis, for example, the relative risk that a child in a high-fluoride environment would score abnormally low (<80) was 1.93 (95% Confidence Interval 1.46, 2.55) compared to those in the reference environment.

3)But how relevant is that heightened relative risk to the issue of deliberate fluoridation of water in the US? Well, first let's note that if we confine ourselves to the studies in the Harvard meta-analysis which involved drinking water (as opposed to fluoride from coal burning), the levels of fluoride in the high-fluoride group were in many cases not that much higher than the amount in deliberately fluoridated water in the US, which is 0.7-1.2 mg/L. In looking at the individual drinking water studies in the Harvard meta-analysis, the high-fluoride group had 4.55 mg/L in one study, 0.88 mg/L in another, a range of 2.1 to 7.6 in a third, 1.8 mg/L in a fourth, 2.97 mg/L in a fifth—that's just to give you the flavor of it. There were 20 separate studies of drinking water which specified the amount of fluoride and in 10 of these the high-fluoride group had levels of LESS THAN 3.0 mg/L, which is not even three times the level in deliberately fluoridated water. What's more, in three of these studies the high-fluoride group's level was 2 mg/L or less. In all ten of these <3.0 mg/L studies, the high-fluoride group had lower IQ than the reference group!!

4)But now let's focus on one of the studies in the meta-analysis, by Lin et al., where the high-fluoride group's level was a mere 0.88 mg/L, or LESS THAN THE TRADITIONAL LEVEL IN DELIBERATELY FLUORIDATED WATER. And yet even in this study, there was an IQ deficit.

5)In the Discussion section of the Harvard meta-analysis they mentioned a study they hadn't included because it was a regression analysis and thus didn't match the type of study they were analyzing. But this study, by Y. Ding et al., published in the Journal of Hazardous Materials in Dec 2010 (available online, as is the Harvard meta-analysis) powerfully reinforces the finding of Lin et al. mentioned in (4). It showed that even when you confined yourself to children whose fluoride exposure was low, there was a clear dose-relationship: the higher the fluoride levels the lower the intelligence level. To quote the study's conclusions: “ Overall,our study suggested that low levels of fluoride exposure in drinking water had negative effects on children’s intelligence”.

6)The Harvard study's authors point out that two well-known neurotoxins, lead and methylmercury, produce damaging effects on developing brains at exposure levels a tiny fraction of that experienced among children drinking deliberately fluoridated water. Consider this comment about lead poisoning: “Although lead poisoning is one of the oldest known work and environmental hazards, the modern understanding of the small amount of lead necessary to cause harm did not come about until the latter half of the 20th century. No safe threshold for lead exposure has been discovered—that is, there is no known amount of lead that is too small to cause the body harm.” Why should we ASSUME, as fluoridation advocates do, that something similar will not eventually be said of fluoride and neurotoxicity in children–there is no known amount of fluoride that is too small to do harm to children's brains?

7)The Harvard study's authors have conducted animal experiments using fluoride levels exactly that of deliberately fluoridated water and have observed morphological abnormalities in the brains of these young rats.

8)Given the triviality of the goal–reduction of cavities–and the ready availability of safe and effective alternatives to water fluoridation (toothpastes, rinses), ANY evidence of harm should eliminate water fluoridation as a viable alternative based on the most elementary cost/benefit analysis.

Kyle Hill, at the beginning of your blog post you breezily proclaimed there was no scientific evidence justifying opposition to fluoridation. Your precise words were: “Simply put, the refusal of water fluoridation doesn’t have any scientific support.”
If you're actually a scientist rather than a mindless spouter of conventional wisdom, you should feel compelled to defend your assertion by dismantling each and every one of the points I raised. We all breathlessly await your efforts.

1) Yes, fluoride is dangerous at very high levels (as are most chemicals). No agency on earth advocates using a level high enough to be neurotoxic.

2) Again, though the Harvard study had nothing to do with studying the effects of regulated water sources, those reviews were dealing with abnormally high levels of fluoride, not the recommended amount that has lead to zero victims over the last half-century. (I am also surprised that you consider one study as “well established.” A body of literature that supports a conclusion is never so bereft of evidence.)

3) We expect adverse effects from 3 to 8 times the recommended dose, of course. I am not sure how you can argue that recommended levels are harmful if two or more times that amount are dangerous. Linking the effects from these levels to regulated 1ppm of less levels isn’t valid.

4) If you are using the meta-analysis to support your case, you can’t pick out one data point from one study. The point of the meta-analysis is to gather data together for more power. By breaking it down, you invalidate the conclusions of the review.

5) See last reply (can’t use a study to support a review that wasn’t included in the review).

6) We “ASSUME” that lead is more dangerous than fluoride at low levels because we have evidence that it is. You say that we can’t assume it isn’t dangerous, but similarly, you can’t assume that it is. That’s not science. We have evidence for lead toxicity at low doses, but not for fluoride at low doses.

7) We have been fluoridating the water of most of the US’s major cities for the last 65 without seeing an accompanying spike in brain abnormalities. I’ll take a few million data points collected over five decades over a rat study conducted in a shoddy review any day.

8)There is no evidence of harm. Everything you mentioned either has nothing to do with fluoride (e.g. lead toxicity), or does not deal with recommended levels. The reality is quite the opposite. Every other review on the subject refutes the singular Harvard review. When you ignore the large body of evidence that refutes your point based on one review, that is the definition of closed-minded. And the cost/benefit analysis yields one of the most cost=effective public health measures in history.

Lastly, you call into question my credentials. I’d say that unless you have the credentials to back up ignoring the fifty other reviews that refute the one review that you used to make all your points, I’d stay away from pulling rank.

You claim to be reviewing the issue with an air of ‘scientific thinking’ yet you cite biased information and discredited studies at the same time. That is one of the many indications that continues to make the people of Portland distrust the overall policy.

This vote was not anti fluoride as blogs like this makes it seem. It was anti-water fluoridation, which is a vastly different thing. There are valid questions revolving the legality of the process that was involved, the sourcing of the eventual chemicals to be used, the oversight that would be in place, the potential for outright corruption in our local political system, consent, and yes the science as well. The science was only 1 facet of the overall conversation.

This attempt at fluoridation only got as far as it did through potentially illegal maneuverings of 3 out of 5 city commissioners set to be permanently out of public office after the decision was made. They were caught taking meetings from pro-fluoride groups monthes before the issue was made public, and at the same time not disclosing those meetings as required by local law. Later on it was found that local government employees were working on pro-fluoride issues on state time, AND that they gave potentially damaging health survey results only to the pro-fluoride side until forced by FOIA order.

The article author states the $1 for every $38 number as though it were fact, when that is quoted data taken from pro-fluoride sources. It originates from a paper done in 1989 published in a peer reviewed journal. That is fine, and seemingly ‘scientific’. Unfortunately they do not include any of the peer review criticism that came out after that publishing.

It was found for instance by the Harvard Medical Review criticism of that same article overstated the benefits and failed to account for many of the costs associated with fluoridation programs. In other words the numbers were rigged to make them sound better then they actually were. This is not some tin-foil hat group scoffing at the white coated scientists. This is the peer review that is supposed to happen before a given data set is touted as fact like this blog entry has done.

A review of the actual science at the NIH and WHO websites actually raises a number of concerns that are scientifically valid. The majority of studies certainly have found ‘insufficient evidence for harm within the scope of our study’ to quote one. That is not to say that it is ‘safe’ or ‘harmless’ just that they didn’t isolate the potential for harm within their particular study.

When you read these papers you will also find an almost universal chorus within the scientific community. Not that we should all be swallowing fluoride en masse. No they nearly all end their papers with a statement that ‘more study is needed’. There we sit, with even the scientists calling for more study, and a number of questions about potential harm.

It is not scientific thinking to just accept the numbers from one side of an issue without individual thought. To do so is just as bad as any claims made by a the tin-foil hat crowd.

No one is harmed by not putting fluoride in the water. Not a single person. No one has ever been harmed, and there is not even potential thereof by drinking pure clean water. The same cannot be said of fluoridated water, however small you think the chances are. We have chosen not to partake in this 65 year open study, as there is a vast and cheap supply of fluoride available to us through other, cheaper, more effective means.

As I read your reply (#63) to my points in #62, I repeatedly found myself asking the question: “Does this guy think he actually is responding in a scientifically meaningful and forensically persuasive way to my points?” I don’t know which is worse: a)That you genuinely believe you’ve presented a compelling case or b)That you realize you haven’t but you’re in too deep psychologically to consider abandoning your position, however untenable it is.

Well, let’s examine each of your points in turn and demonstrate the factual falsity or logical fallacy it contains.

Here’s your first point: “1) Yes, fluoride is dangerous at very high levels (as are most chemicals). No agency on earth advocates using a level high enough to be neurotoxic.”

Mr. Hill, the reason I was so specific in citing the levels of fluoride in the various studies that composed the Harvard meta-analysis was to demonstrate that, compared to the levels in deliberately fluoridated water, the levels were NOT “very high”. First of all, remember that an individual’s body burden of fluoride will be dependent on how much water they drink. A very active child playing sports in warm weather could easily consume three times the amount of water during the day as an inactive one in air-conditioning. Given that the entire population is compelled to consume the fluoridated water, we have to make sure that higher than average, but entirely reasonable, consumption of fluoridated water doesn’t result in neurotoxicity. So the fact that NOT “very high” levels at all (in ten of the 20 drinking water studies the level was less than three times the level in deliberately fluoridated water) were associated with lower IQ immediately signals a threat.

Your second point:”2) Again, though the Harvard study had nothing to do with studying the effects of regulated water sources, those reviews were dealing with abnormally high levels of fluoride, not the recommended amount that has lead to zero victims over the last half-century. (I am also surprised that you consider one study as “well established.” A body of literature that supports a conclusion is never so bereft of evidence.)”

Mr. Hill, you outdid yourself here: 4 separate major errors in three sentences. a)The fact that the Harvard group didn’t study “regulated” water sources is irrelevant–what’s pertinent is the level of fluoride in the water. b)”those reviews were dealing with abnormally high levels of fluoride”–as I indicated in my response to your first point, this simply isn’t true: many of the studies in the meta-analysis (10 of 20 drinking water studies with specified values) had fluoride levels less than three times that of deliberately fluoridated water. c)”zero victims over the last half-century” How glib you are Mr. Hill in declaring zero victims!! If you have minimal honesty you’ll acknowledge that we’ve never looked for victims of neurotoxicity from deliberately fluoridated water either because it wasn’t grasped that that was a real possibility or because those committed to fluoridation had staked their reputations on its safety. But we can extrapolate from recently compiled data that there surely is a high probability of measurable harm to developing brains from deliberately fluoridated water, particularly in those who consume above average amounts. d)You’re surprised I “consider one study as ‘well-established’”. And you add that a “body of literature that supports a conclusion is never so bereft of evidence”. Here’s where I actually shook my head in disbelief. You’re a science writer and yet you call a meta-analysis “one study”?? Do you really not understand that a meta-analysis can, with exquisite statistical exactness, tell us the true meaning of an entire body of evidence, some of whose parts may be inconclusive when taken by themselves? What you foolishly call “one study” was in fact 27 studies, and comprises the entire body of knowledge regarding the differences in children’s intelligence between higher and lower fluoride groups. So it’s the digested meaning of 27 studies that was presented in the Harvard meta-analysis, and some of the 27 were studies not utilized by Western safety panels because they were in untranslated Chinese until now. In science, when a meta-analysis takes all relevant studies and extracts a highly statistically significant conclusion from them, that conclusion is “well-established”.

Your third point: “3) We expect adverse effects from 3 to 8 times the recommended dose, of course. I am not sure how you can argue that recommended levels are harmful if two or more times that amount are dangerous. Linking the effects from these levels to regulated 1ppm of less levels isn’t valid.”

Again, you show an inability to make crucial distinctions. As I laboriously pointed out in #62, and once more in this post, 10 of the 20 drinking water studies with specified levels had less than three times the recommended dose. If you’d read #62 carefully you’d see how I slowly, carefully, methodically tighten the noose around deliberate fluoridation’s neck. First see if fluoride amounts higher than, but not that much higher than, 1 ppm point in the direction of lower IQ. Yes, they do. Then, examine two studies, Lin et al. and Ding et al. that involve fluoride levels on a par with those of deliberately fluoridated water. Both of those studies showed a lowering of intelligence with higher fluoride levels as well, with Ding’s regression analysis achieving high statistical significance.

Your fourth point: “4) If you are using the meta-analysis to support your case, you can’t pick out one data point from one study. The point of the meta-analysis is to gather data together for more power. By breaking it down, you invalidate the conclusions of the review.”

If you had actually read the Harvard meta-analysis you’d have seen that the authors list each one of the 27 studies individually and describe its conclusions. Unfortunately, they don’t give the p-value of each component study’s findings, but every one of the drinking water studies had the same directional OUTCOME: lower intelligence in the high fluoride group compared to the control, though not necessarily to the point of statistical significance. Think about what this means: the researchers utilized every single study in existence that measured intelligence differences in children based on fluoride consumption, including some studies never before available to the West, and every single study found that fluoride impaired intelligence. Perhaps some didn’t achieve statistical significance on their own, but nonetheless, in examining ALL AVAILABLE EVIDENCE there wasn’t a single piece of evidence that didn’t POINT IN THE DIRECTION OF a decline in intelligence among the higher fluoride children, including the ten studies where the amount of fluoride was less than three times the deliberately fluoridated level.

Your fifth point: ” 5) See last reply (can’t use a study to support a review that wasn’t included in the review).”

How ridiculous a comment you’ve made! In addition to doing a meta-analysis, the Harvard researchers brought forward in this paper all the evidence implicating fluoride in damaging the brains of children/young animals. So their paper was both a meta-analysis of epidemiological evidence and, separately, a scientific analysis of ALL the evidence of the danger of fluoride to developing brains.

Your sixth point: “6) We “ASSUME” that lead is more dangerous than fluoride at low levels because we have evidence that it is. You say that we can’t assume it isn’t dangerous, but similarly, you can’t assume that it is. That’s not science. We have evidence for lead toxicity at low doses, but not for fluoride at low doses.”

Mr. Hill, my point about the lead was that although humans had worked with lead for centuries, we didn’t grasp until relatively recently how toxic it was to children. Why not? Because we didn’t look. Once we started investigating we found toxicity at lower and lower exposures. The exact same thing is now happening with fluoride. For the first few decades of deliberate water fluoridation no one looked for subtle neurotoxicity. In fact, it was only because of the naturally high fluoride levels in parts of China that it even occurred to scientists that it might present a problem. EVEN NOW, studies DIRECTLY AND EXPLICITLY addressing the question “Does the amount of fluoride ingested by children drinking fluoridated water cause lesser intelligence in them compared to children drinking non-fluoridated water?” DON”T EXIST!! That’s why I had to laugh in disgust when I read your seventh and eighth points.

Your seventh point: “7) We have been fluoridating the water of most of the US’s major cities for the last 65 without seeing an accompanying spike in brain abnormalities. I’ll take a few million data points collected over five decades over a rat study conducted in a shoddy review any day.”

How could we have seen a “spike in brain abnormalities” when we haven’t looked? That’s what’s so appalling. Not only did we begin fluoridation without conducting careful neurotoxicity studies beforehand, but even now that it’s been underway 65 years, we STILL HAVEN’T CONDUCTED THE NECESSARY STUDIES!! We’re forced to draw inferences from studies conducted for other purposes, in other places.

And your reference to the researchers’ “shoddy review” is a baseless insult that is beneath even your standards.

Your eighth point and valedictory note: “8)There is no evidence of harm. Everything you mentioned either has nothing to do with fluoride (e.g. lead toxicity), or does not deal with recommended levels. The reality is quite the opposite. Every other review on the subject refutes the singular Harvard review. When you ignore the large body of evidence that refutes your point based on one review, that is the definition of closed-minded. And the cost/benefit analysis yields one of the most cost=effective public health measures in history.
Lastly, you call into question my credentials. I’d say that unless you have the credentials to back up ignoring the fifty other reviews that refute the one review that you used to make all your points, I’d stay away from pulling rank.”

You say there is no evidence of harm. I have loudly and angrily pointed out that, to the shame of the fluoridation advocates, they dared to implement fluoridation without ever conducting a single randomized, blinded, controlled trial on children’s brain development consuming versus not consuming deliberately fluoridated water. And to this day, there still hasn’t been such a study or even an epidemiological study of children’s intelligence taking advantage of the fact that some parts of the US had fluoridated their water and some hadn’t. So there’s no (direct and explicit) evidence of harm because no studies have ever been done on this exact question. So we must use surrogates, and make reasonable extrapolations, as I and as the researchers I’ve cited have done. You say I’ve “ignored the large body of evidence that refutes [my] point”. Can you not grasp that not only is there not a “large body of evidence” that refutes my point, there’s no evidence! That’s because all the studies establishing the safety of fluoridation don’t involve comparing two groups of children in terms of their intelligence and their consumption of fluoridated or non-fluoridated water. According to the Harvard researchers, for their meta-analysis, they gathered EVERY SINGLE STUDY making such a comparison that had ever been done, including many that had been ignored in the West because they were in untranslated Chinese. This composes the entire body of evidence most relevant to the question we want answered about neurotoxicity in children, and EVERY SINGLE ONE of those drinking water studies pointed in the direction of lower intelligence in the higher fluoride group. But because, Mr. Hill, your fellow advocates of fluoridation have never in 65 years carried out a single study specifically comparing the intelligence of children drinking deliberately fluoridated water with those not drinking it, we can only say that the EVIDENCE MOST CLOSELY RELATED to that issue points strongly in the direction of more fluoride=less intelligence.

And finally your response to my cost/benefit analysis point, where I said “Given the triviality of the goal–reduction of cavities–and the ready availability of safe and effective alternatives to water fluoridation (toothpastes, rinses), ANY evidence of harm should eliminate water fluoridation as a viable alternative based on the most elementary cost/benefit analysis.” and you said “And the cost/benefit analysis yields one of the most cost=effective public health measures in history.” You evidently feel money saved by not filling as many cavities justifies the very real risk of damaging the brains of millions of children. I’ll let the readers decide what that says about you.

“This vote was not anti fluoride as blogs like this makes it seem. It was anti-water fluoridation, which is a vastly different thing.”

I think you are making the right point. If someone were to propose a ban on the availability of fluoride in Portland it would be defeated by a larger margin than this measure way. But I think this point can go further: it’s not that all the people voting against the measure believe that water fluoridation is universally bad, though certainly some do, but rather that this option, and the way it was handled, and the costs, and numerous other factors made it seem like the wrong choice for Portland at this time, especially when there are other policy measures which could be adopted.

Which is to say, despite insults that this was all about ideology, this was all about context (a complicated one at that). By trying to get the city government to push this through, the water fluoridation proponents may ultimately have been their own worst enemies.

Kyle Hill echoes many of the arguments we have heard in Portland over the last 9 months. It is stock material from the campaign to fluoridate. We used reason, and evidence, not fear. I do not accept the fear-mongering charge. For one, Hill writes “Advil and Tylenol are toxic at high enough concentrations”. Yes, and these drugs are contra-indicated even in low doses for liver patients! Then “Where is the anti-chlorine lobby? Chlorine is a chemical—also an ion—added to water, also considered one of the greatest public health measures in history” Unlike fluoride, chlorine can be easily filtered out, with charcoal filters or evaporation. He continues “It too is proven to reduce disease and create a more healthy population” Chloride is added to counteract pathogens BORNE BY WATER. Hill goes on “Chloride has all the attributes that make fluoride “scary.” When an identical situation produces almost no blowback, it speaks to the basis of fluoride fear. It’s not science.” The author effectively denies the existence of distinguished scientists like Dr. William Hirzy and Dr. Arvid Carlsson, who have studied fluoride, testified against it, and been ignored by policy makers in Portland and elsewhere in this country. Hill asks “Should we have the freedom to refuse a critically important public health measure?” The phrase “critically important public health measure” is subjective and hyperbolic. If fluoride is so critical why flush 99% away with the bathwater? “Science can lead a man to fluoridated water, but it can’t make him drink.” This is simply a glib line, delivered after a couple of paragraphs of asking whether or not we are really qualified to have a right to decide for ourselves. In addition to the medical sensitivities of many people, we have serious concerns regarding the way this was presented in Portland, with backroom deals, improper pressure on state and local officials, character assassination, guilt by association, paid flacks, and blatant refusal to debate scientists who oppose the practice, like those I mentioned above. We had 200 doctors and dentists practicing locally who opposed this. The Sierra Club and local environmental groups were against it. These are not exactly anti-science types; environmentalists often invoke science in arguments for environmental regulation. The rivers around the country have been degraded by pharmaceutical pollution and we have been encouraged to reduce this problem by returning prescriptions to doctors offices and pharmacies for proper disposal. Why is it “anti-science” to oppose adding over a million pounds of fluoride to our downstream aquatic environment?
Conspiracy or not, there is some agenda at work here beyond saving poor people’s teeth. We have a commonsense attitude here against fluoridation. We want our water free of any agenda other than it’s basic life-sustaining role in hydration, hygiene and sanitation. We agree tooth decay is bad, but the scatter-gun approach of community water fluoridation is reminiscent of the era when they would spray whole towns with DDT, because everyone could agree, mosquito bites are bad.

After reading the article and comments, I have gone from being a fluoride advocate to opponent. Here are the three main reasons why:

1) The daily consumption of fluoride in a water supply varies widely over the population. A guaranteed required dose cannot be assured in the majority of the population without also risking an overdose in others.

2) The availability of alternatives combined with the individual’s ability to control dosage is a much better alternative.

3) The reduction of tooth decay is a relatively trivial goal. Those who have an opposing opinion on this assertion should read opposition #2.

Lastly, in the case of Portland, it should be remembered that their tooth decay rate is already significantly below the national average. This suggests that Portlanders already take oral health seriously. Is there any evidence that fluoride added to the diet of those practicing good oral hygiene experience any reduction in the incidence of cavities?

“After reading the article and comments, I have gone from being a fluoride advocate to opponent.” — jh443

It’s quite common on internet forums to see a statement like the one you just posted, purporting to represent and actual change-of-mind. I have no idea in your individual case whether you are telling the truth or not but I do know that whenever a forum-poster makes this type of claim (formerly on one side, now on the other), that claim is suspect.

All BS meters register at least some positive reading when encountering such claims. Sorry, that’s just the way it is.

Check the data. Science may say that fluoride helps, however, in practice the results do not concur. Non fluoridated cavity rate is approximately the same as fluoridated. Sorry, but there’s a difference between theory and practice. Congrats to Portland for keeping your water clean!

Taking into account the widespread use of fluorinated toothpaste, and the real risk of fluorosis, because an excessive Fluor intake, pediatricians in many places prescribe kids any kind of Vitamins and Minerals supplements, with the exception of those containing Fluor, that are discouraged. Local available amount of Fluor in tap water with no supplementing is to be considered, as it’s easy supplementing or ingesting too much, and also the systems that add Fluorine to tap water are probably not enough precise and reliable, and there are also many variations from person to person in the daily amount of water they drink, tap water is not the only source of Fluor, and probably, as in any other issue concerning health, you must indidualize choice for every case. Fluorosis by excess Fluor may be much worse than poor intake of it, and poor Fluor intake is not the only cause of caries. Is the protection coming from Fluor supplements greater than the one reducing sugar use and other healthier food habits gives? I don’t know.

Sigh … Kyle, I’m very disappointed with this article and even more with your subsequent comments. I too initially supported water-fluoridation, but having reviewed the more recent research, I’ve changed my mind, and you should reconsider too, by actually reading the evidence, pro & con, with an open mind. It is clear you have not seriously considered anything other than your preconceived position – and have simply used a ‘confirmation bias’ closed-mind in cherry-picking what to cite.

I drink non-fluoridated water from Bull Run, just outside of Portland. I didn’t get to vote on the issue, so pro-water fluoridaters would have been making decisions for everyone downstream … thank goodness the ‘crowd wisdom’ of Portland got it right.

I used fluoride pills for my daughter 2 decades ago … easy to get if you want them, as noted by a number of commenters. And, of course, one gets fluoride from other sources as well, including toothpaste. Further, there is decent recent evidence that in Portland, and in Oregon – see Kaiser & Oregon studies already cited – there is NO discernable benefit from water fluoridation of Bull Run water. I have studied the various sides, including the fact that many European nations have STOPPED water fluoridation, and am appalled that you continually assert that there is NO evidence of harm — you are essentially denying/lying now, having been given citations to studies showing harm. Whether, on balance, you want to adhere to ‘my science is better than your science’ is one thing – it is another to say there is no evidence on the other side.

Having considered more recent research, I have changed from pro-water-fluoridation to anti – most of the research you cite is dated, and as others have pointed out, of low ‘scientific’ quality. I hope you are aware of meta-analysis standards such as the Cochrane – which have found topical applications more important than systemics such as fluoridated water –

It isn’t just ‘John Birchers’ who oppose adding more chemicals to the water – liberal Portlanders (70% registered Democrat party – again, check your facts), many of whom are outspoken eco-conscious, joined with the Sierra Club – that bastion of … no, not right-wing-nuts … in opposition to additional chemicals to Bull Run. On balance, with NO benefit shown from Portland & Oregon specific studies, versus various concerns about harm – not just to some people, but to the environment, including water life – it was perfectly rational to rely on recent scientific evidence to conclude that water fluoridation was not necessary, and perhaps harmful. Don’t insult me & my fellow Oregonians by claiming that because we don’t agree with you we must be stupid … I’ll gladly match & raise your qualifications with various opponents to water-fluoridation.

For example, Please directly address the following statements from panel members of the NRC 2006 report – already cited in previous comments, and why you think they aren’t qualified to speak to this issue:

Dr. Robert L. Isaacson: “I had no fixed opinion on whether or not fluoride should be added to drinking water … Slowly, I came to the conclusion that there were strong experimental and clinical indications that fluorides present health hazards to people in many ways. The more I learned, the more I became convinced that the addition of fluorides to drinking water was, and is, a mistake.”

Dr. Hardy Limeback: “The evidence that fluoridation is more harmful than beneficial is now overwhelming.”

Dr. Kathleen Thiessen: “Elimination of community water fluoridation at the earliest possible date would be in the best interest of public health.”

And please tell us why these 3 Drs chosen for a national panel review, and all the other scientists who are opposed, are somehow inferior to whatever ‘qualifications’ you might have? Your bio doesn’t disclose any particular qualifications superior to the various scientists who have expressed opposition. See also those cited in the wiki article on this: & others – ‘The U.S. Department of Health and Human Services announced plans … to lower the recommended level of fluoride in drinking water for the first time in nearly 50 years, based on a fresh review of the science.’ http://www.southcoasttoday.com/apps/pbcs.dll/article?AID=/20110108/NEWS02/101080340&cid=sitesearch ; ‘Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries over the past thirty years. It is now time for a scientific re-examination of the alleged enormous benefits of fluoridation.’ http://www.nature.com/nature/journal/v322/n6075/abs/322125a0.html – ‘To prevent further lower back pain, we recommend that the water in this area be treated to reduce its fluoride content.’

Mind your own business. We’ve had people try to push fluoride down our throats four times in the last 50+ years. This time we were out spent 3-1 and we out voted you 2-1. We aren’t mindless sheep who just do things because other US cities do them. We are informed and inquisitive. Why doesn’t the rest of the world fluoridate? The US is ranked #36 in the world for health care and we’re supposed to do it just because other americans do it? We’re not stupid, we know how to use a toothbrush. We have the 15th lowest cavity rate in the nation on one of the lowest cavity rates in the state and we don’t fluoridate our drinking water.

I’ve been in the water utility industry for three decades. Yes, chlorine is an effective disinfectant. But, a safe chemical? DON’T GO THERE!

IF CHLORINE IS SO SAFE, why does the Department of Transportation make me use a skull and crossbones placard (UN 1017)on my truck to transport it on public highways?

IF CHLORINE IS SO SAFE, why do we have annual hazardous response training to deal with chlorine leaks?

IF CHLORINE IS SO SAFE, why did the local Air Force Base ban chlorine as too dangerous to have on their property where the new county wastewater plant was built? Don’t worry, the drinking water is being disinfected with a system that uses Ultra-violet light WHICH, by the way, is known to be effect in killing giardia and cryptosporidium (crypto causes 100,000 deaths a year world wide and 800,000 infections here in the US), often deadly organisms for which Chlorine is known to be INEFFECTIVE.

IF CHLORINE IS SO SAFE, why does the EPA have maximum limits for public water supplies on total and free chlorine or disinfection by-products of chlorine compounds such as Trihalomethanes (believed to be carcinogenic if ingested in quantity) in the parts per BILLION range.

Really, I would have thought that a science writer would place the emphasis on science and ask questions before writing.

I’m a fan of appropriate use — topical application. But totally against wholesale ingestion where dosage cannot be controlled — i.e. it all depends on how much water one drinks, not how much one needs.

I want to decide if I should use it based on the advice of a medical professional, my dentist, NOT based on a vote by a City Councilperson or a Water Board Trustee.

Ask yourself this: How many years was lead paint or asbestos insulation considered safe and effective?

The conspiracy-driven, scare tactics of some opponents to flouridation in Portland is surely a bit ridiculous… because, it’s politics and that’s how people motivate others in politic today. That’s not unique to Portland and that not unique to this issue. Maybe less extreme, the proponents of the measure also framed the issue as “Add Flouride, and no child will ever have dental issues in Portland again… oppose it and all of the kids’ teeth will fall out.” which is clearly, again, an oversimplified scare tactic. It works both ways.

But c’mon, give some of us a little credit… Some of us who voted against the measure are simply uncomfortable with the idea of using an entire region’s water supply as a medicine delivery system to a very small, very specific portion of the population who are mostly already receiving free fluoride on a regular basis in a much-better targeted public school program. How was this better than that current system?

While your tone and suggestion are obviously correct for some opponents, casting all of us who voted against the measure as simply being weirdo conspiracy theorists is painting with bit of a broad brush, yeah?

Kyle, your posting seems to imply that anyone who voted against fluoridation in Portland is either scientifically illiterate or a conspiracy-theorist. As a long-time reader of Scientific American, I decided to see what SciAm had to report of fluoridation and found their 2008 article titled “Second thoughts about fluoride”, which informed my NO vote.

At the conclusion of your article, you say, “Until political questions are seriously informed by scientific answers, fear and freedom beats facts.” And here I thought I was using the science from a trusted source to make my decision.

I realize the article itself doesn’t come out for and against fluoridation. However, the position made by fluoridation supporters is that the evidence is all in and that anyone opposing fluoridation is a conspiracy-theorist.

Unless you do a study on why people voted the way they did, you appear guilty of your own conspiracy theory. You have written a patronizing article about Portland voters without any facts about why they voted as they did. I think you owe us an apology.

This is a dark day for Portland. And as usual, the real story is completely lost in the confusion.

This is not about fluoridation; it never has been. This is about the government keeping tabs on people who cannot be easily controlled by propaganda.

The way it works is, the government proposes an obviously absurd initiative, like adding poison to our drinking water. Then it arranges for a vote on the issue. It doesn’t matter one bit what the results of the vote are; obviously the government isn’t really going to put fluoride in the water either way. It’s the vote itself which was the point of the exercise.

To all the people who voted ‘No’ to fluoridation, congratulations. You have just let the government know that you are an intelligent freethinker who doesn’t just follow the herd. Your name is now on a list of people who cannot be easily controlled. They know who you are, and they will be coming.

So, Portland has flouridated and nonflouridated areas. I assume there are other differences between those areas, yet it seems like a simple epidemiological study could be done? Is there an absurd number of retarded children in the flouridated areas? Are people plagued at unnatural numbers with unnamed ailments, or dying of cancer at a young age?

why is scientific american and the govt. pushing fluoride so hard? why are you guy’s so concerned about our teeth? wouldn’t it make more sense you guy’s push vitamins in the water for our health ? what is it about our smiles that is so important to you. If you could answer those questions then maybe we might drink the koolaid ! come on everybody it’s that simple ! why do they care about your teeth so much over the health of your brains, organs and so on ? the answer is they DON’T really, how does drinking fluoride even get to your teeth ? wouldn’t swishing it around in your mouth and spitting it make more sense. It’s so simple to see the deception. they want you to ingest it, they want it to circulate throughout your body no conspiracy theory could be that obvious, wake up !!! and i dare this magazine scientific “american”? to refute the simple logic i have posted ! I CHALLENGE YOU SCIENTIFIC AMERICAN

I looked at this issue a few years ago, reading what studies I could find. The Science seemed inconclusive with respect to benefits. Drinking fluoridated water may not help teeth much at all. The dangers of fluoridation seem to be real, especially for children. Fluoride in toothpaste appears to work much better. The fluoride is applied to the teeth, where it is beneficial. It can be controlled better also, allowing for individual choice.

The people of Portland certainly had justification for their choice, and people who do not live there should quit meddling.

Most of these points appear in other comments. What does not appear, and the point I want to make, is that people are justifiably suspicious of government and corporate programs (for our “benefit”) when there is so much deception and secrecy. We can not find out if our food is genetically modified, or what is added to our food, our water, or our environment. (For example, many “fertilizers” are made with industrial waste and contain deadly toxins. In some fields in Washington, the toxic levels got so high nothing would grow there. Who knows how many people are being poisoned by eating that food. When local media exposed this scandal, Washington politicians actually took some action. But in most states, toxic fertilizer is still used, and the farmers are not told anything about it. Nor is the public.) This is just one example. We all have numerous examples of how government and corporate spokesmen have lied to us and kept their dangerous practices secret. This naturally makes any informed citizen wary, and rightly so. If we can not trust the “authorities” and we don’t know if something is safe, it is better and safer to accept the precautionary principle — and where we can, just say NO.

I agree this can result in bad decisions, as it did with the anti-vaccine campaign. But if the “authorities” want us to trust them, they need to stop lying to us and keeping secrets. They need to be open and honest. Only then can we begin to trust them again.

And the news article to which Kyle refers seems to be a study based on =topical= application, not a community-based water supply: “We tested the adhesion … after treatment with fluoride solution. All bacteria species exhibit lower adhesion forces after fluoride treatment of the surfaces.” http://pubs.acs.org/doi/abs/10.1021/la4008558

This article is semi-ridiculous. First, I love the argument that even tylenol and advil are “toxic” at high levels. But who wants tylenol and advil added to their water supply?? Come on now. That’s really reaching. Tylenol and advil and other “drugs” are supposed to be used only as necessary and in moderation and in some cases on a prescription from a doctor. And some people choose not to use it at all, and they have the right to do so. So…taking advil and tylenol or not is really not at all like fluoridating and municipality’s entire water supply!!!

The bottom line is that unnaturally occurring chemicals that can’t be processed by the human body get stored and accumulate in soft tissues and can have adverse affects. Hence the primary reason people cleanse–or should cleanse–the body periodically. So then instead of consuming immediately deadly levels of poison, drinking “fluoride” (which really isn’t fluoride at all) is just “slow poisoning” depending on how much one comes into contact with fluoridated water. And you’re telling me that people shouldn’t have a choice to drink fluoride? That they should all have to accept medication?

Also, you say that people get relatively low levels “from a glass of water,” but how many glasses of water does one consume daily? Weekly? Annually? And what about showering, bathing, swimming, brushing teeth? Have you forgotten or simply not found it relevant to take into account that the skin is also a semi-permeable organ? Drinking is not the only way to take substances into the human body. So then what’s the use of fluoride once over the teeth–if at all–and in the body? Will it whiten my bones and keep plaque from forming there? Or is it possible that as it stores in the tissues, that there could actually be harm done over time? Like the studies suggest. It is, after all, comprised of “toxic,” “corrosive,” and “hazardous” substances not recommended for human contact, ingestion or inhalation. Period. In any dosage. You can read the scientific fact sheets to confirm that data, by the way.

And I 100% agree with the individual who said that the decision to fluoridate water is a decision of private, corporate interest and not true public health (if anyone thinks fluoride is that naturally occurring element on the periodic table, you’re wrong–it’s phosphate mining waste, and the EPA classifies it, labels it and transports it as a “poison”; in “fume” form, it used to kill livestock and crops before it had to be reclaimed). So basically the phosphate mining industry gets to turn a profit and ultimately dispose of its waste anyway, waste it was never supposed to be allowed to release into the environment. And from what I can find, there is documented evidence based on real studies showing little or no benefit to using fluoride for teeth, and actually many that show adverse affects on the teeth AND body. So with little documented proof showing benefit and lots of questions raised about safety, you are going to tell me this is mostly a matter of true public health? I supposed you are going to make the same argument for dangerous genetically modified crops too, which create tumors and cause sterilization in rats and disease and death in livestock, not to mention the reported affects on human consumers or the rights of farmers to save their seeds being taken away. That that too is a matter of public health and not private and political interest?

And speaking of, the problem you have with the campaign against fluoridation using an effective poster…what about the countless times in history that corporations have used intense and effective propaganda based on their own findings and opinions? No problem with that, then? Just when the people of Portland do it. Got it.

Also, like some of you, I too have lived without drinking fluoridated water for about 15 years, since I was a teen. I have not had a single cavity or tooth problem at all in that time. In fact the only cavity I have ever had occurred while I WAS drinking fluoridated water, before my mom wised up and got us a filtration system on the house. In addition to filtered water, over the last 6 years I have been drinking water from our own well and we use non-fluoridated toothpaste. My husband has never had a cavity, my toddler daughter’s teeth are healthy, and my dentist literally remarks at the tremendous health and whiteness of my teeth every time I go in. Before I politely ask for “no fluoride please.”

Come on Scientific American, what is “scientific” about this article?? I second the motion to have it removed.

And another thing: Kyle, you may want to verify your claims before making them. You inform audiences in one of your comments that “…the majority of Europe has been fluoridating with great effectiveness for the last half-century”). Nope. Wrong. The VAST majority of Europe does not fluoridate, very few countries do. I suggest simply googling, “Does Europe fluoridate its water?” Not too much to ask of a research fellow is it? http://www.fluoridealert.org/articles/fluoride-facts/. A second question for you: what would YOU consider to be “great effectiveness”? Have fluoridating nations and states cured tooth decay?! Have the rates at least plummeted to markedly low numbers? Seems it’s actually made little detectable difference according to the findings of SEVERAL studies. The rates are virtually the same between those fluoridating and not, and as someone mentioned, the people of Portland have healthier teeth than many others in fluoridating areas. So the big question on everyone’s mind should be, “If there are no proven benefits, is it necessary? And furthermore, is it safe?” The jury may still be out according to you and others failing to rightly question this practice, but that is more than enough to have people, like the good people of Portland, second guessing it and/or not wanting to drink it–or have their children drink it–every day. If I am incorrectly assessing your claim and definition of “great effectiveness,” perhaps you want to enlighten me and most of the rest of us who are scratching our heads.

Kyle Hill I will give you only one reason why fluoride should never be introduced into the water system as at was here in Queensland by the previous state government premier who railroaded fluoridation through parliament against the peoples wishes, as we had voted on it years ago, and she had agreed it was a dead issue, but as usual she lied to us, and forced it through.

That ONE reason, because one person in 2.5 million are allergic to it! and it can kill them! One sip of the that crap and my grandson would be dead in three minutes and there is nothing we could do to save his live, is that something you and all your “save our screaming teeth” banshees are happy to have on your conscious’ because on top of the fact that fluoride is an unknown quantity, it is a KILLER to many!

Fortunately we live on acreage and have tank water, and use quality filters, and yes filtration DOES get rid of the shit.

Do your research properly before you do your expose on how Portland got it wrong, they Democratically voted against it, so how can you have the nerve to say they got it wrong, and this coming from and American, who like us Aussie’s are suppose to be willing to fight for democracy! How dare you.

BTW He is 6 yrs old and still has all his first teeth, which he started getting at two weeks, with no cavities at all!

Compared to his cousin in town who uses fluoride toothpaste and drinks the water, is a year younger has lost 3 teeth and has cavities in a number of the rest, his mother cant wait for them to fall out and eats less lollies than my grandson does.

It is shocking that this kind of ill-researched article makes it into my beloved Scientific American.
CDC admits 40+% of young adults suffer from fluorosis. CDC admitted in 2006 that the only possible effectiveness of fluoride was topical, not systemic, and by 2009 ADA and CDC both admitted that infants were often over exposed due to fluoridated water being used for formula. The list of dangerous side effects has been documented with a growing list of studies, and the original science from Mr. fluoride himself, Dr. Frederick Stare, head of the Nutrition Dept at Harvard was exposed as bogus already in the 70′s when European countries began rejecting fluoride. Not only was he funded by the sugar and cereal industry, and a bad case of science for hire, he actively suppressed damaging information about fluoride from being pursued and published by a researcher in his department. This is one of the biggest scientific frauds of all time.

YOU ARE WRONG ABOUT FLUORIDE
and if you want it, then stay out of Portland!
Portland’s voting populace is on average more informed than you, a Blogger for Scientific American.
This is a shining example of democracy working for the people,
rather than against as is usually the case.
And the Assault on Portland’s drinking water isn’t over
The EPA wants more radiation and chemical exposure.
Watch Gasland 2 to see how trustworthy the EPA is.http://www.trueactivist.com/so-why-are-we-still-drinking-fluoride-again/

By characterizing those opposed to fluoridation of Portland’s water as unscientific “cranks” you are being intellectually dishonest. While it probably wouldn’t have been defeated without those credulous idiots, they do not represent the (large) population of those opposed.

Not all of us are opposed to the fluoridation on the basis of unfounded fears. Personally, I am opposed for philosophical and socio-political reasons:

1) This is not based upon any perceived scientifically credible risks from fluoride specifically. Bull Run water is known for its purity. Out of all of the places I have travelled to, I have yet to find ANY with water as pleasant and refreshing as our water. I take a position on this that I rarely take on anything: “If it ain’t broke don’t fix it.” That being said, I completely agree with chlorination, because it has significant support for preventing SIGNIFICANT public health risks.

2) Why should taxpayers fund the poor hygienic habits of other people? Don’t just give the same old false dichotomy of disadvantaged vs privileged either. The problem is more nuanced than that. It would be better to examine the reasons that the disadvantaged have have worse dental hygiene and look for a better solution than wrapping the entire population in foam so they don’t get a boo-boo.

3) Keeping #2 in mind, consider the possibility, that fluoridating the water might actually contribute to people being LESS concerned about their own health and hygiene and more inclined to accept the false sense of personal safety that comes with assuming that “everything will be alright” because their drinking water (or any other external element) will take care of them. That is a dangerous and disempowering worldview.

The author of this is either grossly misinformed or never did any counter research after forming his original thesis statement. Most to all of arguments he made were so blatantly incorrect ! This supposed to be scientific journalism ?

Contaminating the water supply with ANYTHING to treat the population is a very bad stupid idea, PERIOD.
If you want to be treated then do it yourself with anything you chose…

BTW, The EPA scientists, engineers and attorneys who assess the scientific data for Safe Drinking Water Act standards and other EPA regulations have gone on record against the practice of adding fluoride to public drinking water.

I suppose the fact that non-fluoridated Portland had SUCH good dental caries rates that it actually brought DOWN the State rates by 15% has nothing to do with it? Has it to do with the largest survey of dental caries in the USA found NO difference between fluoridated and non-fluoridated areas? Just WHY should anyone in their right mind dump neurotoxins into their and their children’s water on some spurious claims without a health test having been done on that substance (hyrdofluorosilicic acid) ANYWHERE in the world?
“The largest U.S. study comparing tooth decay between those drinking fluoridated vs. non-fluoridated water found a non-significant gain of 0.6 of a surface of a tooth (out of 128 tooth surfaces) for those drinking fluoridated water (Brunelle & Carlos, 1990). Other research shows that there is no relation between dental carries and the amount of Fluoride ingested ( Warren et al., 2009).”
And from the EPA Union: “Regarding the effectiveness of fluoride in reducing dental cavities, there has not been any double-blind study of fluoride’s effectiveness as a caries preventative. There have been many, many small scale, selective publications on this issue that proponents cite to justify fluoridation, but the largest and most comprehensive study, one done by dentists trained by the National Institute of Dental Research, on over 39,000 school children aged 5-17 years, shows no significant differences (in terms of decayed, missing and filled teeth) among caries incidences in fluoridated, non-fluoridated and partially fluoridated communities.\16. The latest publication \17 on the fifty-year fluoridation experiment in two New York cities, Newburgh and Kingston, shows the same thing. The only significant difference in dental health between the two communities as a whole is that fluoridated Newburgh, N.Y. shows about twice the incidence of dental fluorosis (the first, visible sign of fluoride chronic toxicity) as seen in non-fluoridated Kingston.”

If half of the stuff said about fluoride is true then it should be banned. Why do local governments believe that putting a chemical in the drinking supply that is unneeded is safe and proper? The same reason people have been told that eating genetically engineered fruits and vegetables that produce their own pesticides is safe. It isn’t the government that controls what the public is believing it is the corporations that needed to find a way to unload their toxic waste. Why pay to dump it somewhere when you can convince local governments to buy tons of it and put it into the water supply. Humans being essentially have become the fluoride filter. The scientists/ corporations that deemed fluoride safe are the same ones that sold radium dial clocks in the 50′s. You say that a government conspiracy to hide information about fluoride is ludicrous. I agree. The government just goes along with what the lobbyists want. Most European countries have banned or stopped using fluoride because A. it is toxic and B. while it may help whiten teeth there is no real statistical data showing it prevents cavities. Heck even China has banned its use and they probably have mountains of the stuff laying around since they are now the world’s factory. The other issue is monetary. While some argue the money is negligible it is still money that can be used better elsewhere. It isn’t like their aren’t plenty of products people can buy with fluoride in it. I also wonder about its use in bottled water and soft drinks. Does Coca Cola use water with fluoride to produce it products? Does having fluoride in your soft drinks really help with cavities? There is plenty of evidence that the preservatives we use, the pesticides we use, the chemical dyes for food all have a negative effect on our health. Yet, they are still mostly legal. Big Tobacco for decades convinced people that smoking was perfectly safe. How can you are argue that the people that make money off of fluoride don’t guarantee there is amble evidence it is safe. The same people that make this evidence are the ones that are sponsored by large corporations to make sure that people believe climate change isn’t caused by them and that what they put in the air is perfectly safe. Really….

God forbid that the people will pass a law prohibiting the addition of chemicals to their water supply! Shame on them for trying to stop the government from adding a chemical to their water! SHAME on them for questioning the legitimacy of the addition of this chemical to the water supply, in light of our government’s TOTALLY SPOTLESS record of NEVER doing ANYTHING against the interest the people! Those crazy luddites! They should be executed for treason!

It would seem the comparison of cavities in non-fluoridated areas to fluoridated areas would suffice as proof of pro and con fluoridation. Purportedly the best water in the country is in Deaf Smith County, Texas. There is natural fluoridation in the water, more than 1%/ Does that prove fluoridation is king? No, the water is high in sodium, magnesium, calcium (Equal amounts of Calcium and Magnesium), bicarbonate, and several other minerals, I believe their is a minute amount of arsenic, too. Still, the bones that break in Dallas sometimes never heal or heal poorly, the broken bones in DSC always heal and the residents have teeth we only dream of having, all 32, often for life. It’s not the fluoride that does it, it’s the magnesium, calcium and sodium. Insofar as science goes, there’s a rumor floating around the Scientific American rather sides with industry, but it’s only a rumor, however, it wouldn’t be the first time a rumor had some truth in it. What else has Scientific American sided with that was questionable, I think I’ll look up sugar, soft drinks and marijuana.

What an absolutely ridiculous article! It just amazes me that there are proponents to putting Fluoride in our water. Even if we were to say that it does prevent tooth decay, the bottom line is that it shouldn’t be put in the water supply. Sell it in stores for people to purchase if they so CHOOSE!

Since these Fluoridists like to put ‘stuff in the water to replace what we can prevent on our own’ ….why stop there? Why not put statins in the water supply to reduce chloesterol, or antidepressants in the water to diminish the possibility of suicide, or why don’t we throw in low levels of weed to make us all a bit more relaxed?? lol In the end, Fluoride does not prevent what brushing and caring for your teeth will provide. Because of this nonsense, and because our water supplies are in such great dangers. I’ve decided the best thing I can do for me and my son is to get a great filter that filters out the widest range of chemicals, efficiently and cost-effectively.

I’ve done alot of research on this and I could only find one company’s results that I could verify. It’s been really hard to find companies that are truly reputable when it comes to their fluoride removal claims. A lot of companies claim NSF accreditation, but one must be very careful about that and know exactly what the certification is for. Most of the time it does not measure how well the filter removes contaminants.

Just thought I would pass on my findings as I have been researching for myself to ensure we get a quality filter that does what it claims from a reputable company. There is a small company out of New York that I found that has a filtration system (I’m referring to their under the counter ‘ultra’ version…though they have several other configurations) that removes fluoride, prescription drugs, and even radiation via Zeolite. It even raises the alkalinity of the water. They have an independent test done by a nationwide lab analysis company and I also contacted the lab personally to ensure that this company was reputable and that the lab results were not fabricated……anyhow it all checked out. Anyhow, check out the website as it has lots of interesting articles and info, and contact them if you have questions as I did. I think they have an excellent filter …good luck. Here is the link, and if you notice their customer reviews are all top notch, the best that I can find………………… http://www.pureeffectfilters.com/#a_aid=Ultrawater

Article fails to mention it is not fluoride that gets added its hexafluorosilicic acid that gets added. It is a byproduct of the petro-agro industry and it is the same scientists from this industry that support it. Big surprise.

A meta-analysis is not a study? No, it’s a careful review of MANY studies. The article you linked that supposedly refutes the Harvard IQ meta-analysis is very misleading. What you should have done, if you were a conscientious reporter, is interview Anna Choi and Phillippe Grandjean, senior authors of the Harvard review. Anyone here who believes what this hack has written should mosey on over to Grandjean’s blog.And then maybe you should wonder why most of the educated world does not fluoridate. http://braindrain.dk/2013/02/fluoridated-water-and-brains/

Kyle,
You cannot use the generalization that “…the majority of Europe…have been fluoridating with great effectiveness for the last half-century” in the support of your argument. Most of Europe may have fluoridated their water supply in the past but most no longer do so. Germany does not, Switzerland does not, nor does Belgium, Czech Republic, Denmark, Austria, Greece, Finland, Norway, or The Netherlands, in the United Kingdom less then 10% fluoridate, in Spain less than 10%, and in France less than 3%.

Portland has not been wrong yet about Fluoride.
There simply is no statistical reason to add it to the drinking water. Portland has a lower cavity rates than other cities in Oregon that fluoridate.
To state that something is safe because it does not cause a consistent visible health problem for a large number of consumers is a fallacy. There are still potentially thousands of people that have health problems that may be caused or exacerbated by fluoride consumption that simply have not been identified and proven by research yet. If there was a compelling reason to consume this industrial byproduct waste such as a proven reduction in cancers, then an argument could be made. There is not.
When you have a fluoride treatment at your dentist, you swish the material around in your mouth for some time and then spit it out. “Drinking water” is not swished around the mouth and it is swallowed, resulting in the consumption of a large amount of material for a very marginal exposure to the teeth.
There are many health problems already described by others here associated with fluoride consumption. Over exposure to the teeth is damaging as well.
It doesn’t really matter whether industry is trying to get rid of their waste by using the digestion system of people as a dumping target or not. There simply is no good reason to add it to the drinking water because Portland residents already have statistically less cavities than fluorided communities. In addition, the health effects and risks of consuming so much fluoride for such a poor dental exposure is ludicrous.

What is wrong with just water? If there is any question or debate about adding chemicals, then why even add them? Drinking water is for drinking, period. It’s not for cleaning teeth, that is a separate issue. Fluoride is a toxic chemical, that is a fact. When combined with the body’s natural stomach acid hydrofluoric acid is produced. To think that ingesting fluoride into your digestive system is somehow going to prevent tooth decay is ludicrous. Would eating toothpaste help our teeth as well? Scientific American is pushing an agenda.

It’s really simple. Fluoridating water, regardless of the risk or or lack thereof, makes no sense whatsoever. Why don’t we just add fluoride to every last product we ingest, if it’s so good for us? Because it’s stupid. There a long and time tested solution. It’s called topical application of fluoride by using fluoridated toothpaste. End of story.

This is quite the unscientific rant, which is a little unexpected from a scientific site. There are no facts or studies cited. There is only opinion and conjecture. There are many potential ill effects attributed to fluoride – even that which is naturally occurring. The fluoride we put in our water is an unrefined, non-pharmaceutical grade byproduct of phosphate fertilizer production. We really don’t know what all contaminants might be in it, even if we are unconcerned about the ill effects of the fluoride itself. Prior to the fertilizer industry finding this ingenious way to dispose of this toxic chemical which would require a hazmat cleanup in the event of a spill, they had to pay to have it disposed of as hazardous waste. Now, they make money on this hazardous waste instead.

As to the necessity … my 26-year-old son would have an x-ray much like that of the man in the article – with no cavities or other dental work. He grew up drinking only purified water because of ALL of the contaminants in our public water supply – not just the fluoride, and he has never had a cavity or any other problems with his teeth. I know this is an isolated incident of the oral health of just one individual, as is the photo in the article, so it is not conclusive evidence, but it certainly demonstrates that the lack of fluoride has resulted in disastrous oral health in at least one individual.

Also, the citizens of Portland did not, and actually could not, vote not against the regulation of fluoride in their water supply, as implied by the article. They only voted not to ADD any fluoride to the supply. The Environmental Protection Agency (federal government) requires that there not be more than 4.0 mg/L of fluoride in public drinking water (which is, by the way, considerably higher than the 1.5 mg/L recommendation of the World Health Organization), with a secondary standard (which is more of a guideline, and not enforceable) of 2.0 mg/L (to protect children’s developing teeth).

Even with this regulation to the upper limit for fluoride in our drinking water supplies, there is absolutely no manner in which the amount ingested by a particular person can be controlled. There are so many factors in play – other sources of fluoride (toothpaste, some foods, etc.), how much water people drink, whether people drink purified water, etc. Some people drink so much water that in a system that is at the upper end of the 4.0 mg/L limit, or with other sources of fluoride they may find themselves at risk of one or more of the many ill effects.

Treating the water is also a systemic solution to a “problem” that would be best addressed with a topical solution – treating only the teeth with a pharmaceutical grade fluoride.